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KIYAN, GÜRSU

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Author: GÖKDEMİR, YASEMİN × Subject: CHILDREN ×

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    PublicationOpen Access
    An unusual case of childhood sarcoidosis
    (SOC ARGENTINA PEDIATRIA, 2013-10-01) KARADAĞ, BÜLENT TANER; Gokdemir, Yasemin; Ersu, Refika; Karadag, Bulent; Karakoc, Fazilet; Kiyan, Gursu; Kaya, Handan; Kasapcopur, Ozgur; Erdem, Ela; Dagli, Elif
    Sarcoidosis is a systemic granulomatous disease of unknown etiology that may affect many systems, mainly lungs. Most of the patients present at stages I and II lung involvement. Pulmonary infiltrates without hilar lymphadenopathy (state III) rarely occurs. Extrapulmonary organ involvement is common in pediatric sarcoidosis. The aim of this report is to present an unusual case of childhood sarcoidosis with stage III lung involvement without any extrapulmonary organ involvement. A 7-year-old girl presented with the complaints of malaise, fatigue, weight loss and dyspnea. There was patchy, bilateral ground glass view at high resolution computer tomography. Video assisted thoracoscopic lung biopsy was performed and histopathological examination showed nonnecrotising epitheloid-cell granulomas with giant cells. She did not have any hilar or extrapulmonary organ involvement and pulmonary sarcoidosis at stage III was diagnosed. Sarcoidosis should be considered in the differential diagnosis of children with interstitial lung disease.
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    Long-term respiratory outcomes of post-op congenital lung malformations
    (WILEY, 2021) KARADAĞ, BÜLENT TANER; Dincel, Alican; Yilmaz Yegit, Cansu; Ergenekon, Almala Pinar; Erdem Eralp, Ela; Gokdemir, Yasemin; Kiyan, Gursu; Karadag, Bulent
    Background Congenital lung malformations (CLM) are rare disorders and surgical intervention is the definitive treatment. Our aim is to evaluate the long-term lung function of patients with CLM after surgery compared to healthy children. Methods Sixteen children with CLM (M/F: 9/7) and 30 age-matched, healthy controls (M/F: 13/17) were included in the study. Demographic data were recorded and both groups were compared by spirometry and the nitrogen-based Lung Clearance Index (LCI). Results Mean +/- SD age of the patients was 12.0 +/- 5.4 years. The mean forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and forced expiratory flow between 25% and 75% of force expiration (FEF25-75) predicted was, 86.68 +/- 16.65, 88.00 +/- 14.58, 97.44 +/- 9.89, and 79.00 +/- 26.41, respectively in the patient group. Patients with CLM had significantly lower values in FEV1, FVC, FEF25-75 than healthy controls (P = 0.002, P 0.007, P 0.045). While the mean LCI2,5% value in patients' group was 8.33 +/- 1.52, it was 7.28 +/- 0.80 in healthy controls (P = 0.023). Strong inverse correlation between LCI and FEV1, FEV1/FVC was detected in the patient group (P = 0.023; r: -0.581, P 0.017; r: -0.606 respectively). Conclusion This study revealed that, in long-term follow-up, patients who had surgery because of CLM have impairment in the pulmonary function compared to healthy children and LCI may be more accurate in detecting airway diseases early than spirometry.
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    Pediatric flexible bronchoscopy in the intensive care unit: A multicenter study
    (WILEY, 2021) ERGENEKON, ALMALA PINAR; Atag, Emine; Unal, Fusun; Yazan, Hakan; Girit, Saniye; Uyan, Zeynep Seda; Ergenekon, Almala Pinar; Yayla, Esra; Mertturk, Edanur; Telhan, Leyla; Meral, Ozge; Kucuk, Hanife Busra; Gunduz, Mehmet; Gokdemir, Yasemin; Eralp, Ela Erdem; Kiyan, Gursu; Cakir, Erkan; Ersu, Refika; Karakoc, Fazilet; Oktem, Sedat
    Introduction Flexible bronchoscopy (FB) is frequently used for assessment and treatment of patients with respiratory diseases. Our aim was to investigate the contribution of FB to diagnosis and therapy in children admitted to the intensive care units (ICU) and to evaluate the safety of FB in this vulnerable population. Methods Children less than 18 years of age who underwent FB in the five neonatal and pediatric ICUs in Istanbul between July 1st, 2015 and July 1st, 2020 were included to the study. Demographic and clinical data including bronchoscopy indications, findings, complications, and the contribution of bronchoscopy to the management were retrospectively reviewed. Results One hundred and ninety-six patients were included to the study. The median age was 5 months (range 0.3-205 months). The most common indication of FB was extubation failure (38.3%), followed by suspected airway disease. Bronchoscopic assessments revealed at least one abnormality in 90.8% patients. The most common findings were airway malacia and the presence of excessive airway secretions (47.4% and 35.7%, respectively). Positive contribution of FB was identified in 87.2% of the patients. FB had greater than 1 positive contribution in 138 patients and 80.6% of the patients received a new diagnosis. Medical therapy was modified after the procedure in 39.8% and surgical interventions were pursued in 40% of the patients. Therapeutic lavage was achieved in 18.9%. There were no major complications. Conclusion Flexible bronchoscopy is a valuable diagnostic and therapeutic tool in neonatal and pediatric ICUs and is not associated with major complications.